This is a condition where tissue similar to the lining of the uterus, grows on pelvic organs outside the uterus such as on the ovaries or fallopian tubes. This tissue responds to the fluctuating hormones in the menstrual cycle the same way as the lining of the uterus does, so will grow and then bleed every month. However, the blood has noway of leaving the body so can cause scar tissue to develop, pain and inflammation. Endometriosis is also associated with fertility problems.
The direct causes are unknown however it may be due to retrograde menstruation whereby some of the uterus lining moves up the fallopian tubes and attaches to the surrounding organs rather than leaving the body during menstruation. It has also been linked to issues with the immune system through the spreading of endometrium cells by the lymphatic system.
What are the symptoms?
The symptoms may vary, some women can have little to none while for others it is incredibly painful and debilitating.
Symptoms are mainly felt during your period and include:
· Pelvic and tummy pain (typically this worsens during your period)
· Severe period pain which prevents daily activities
· Painful sex
· Pain when urinating
· Painful bowel movements
· Blood in your urine
· Extreme pelvic cramping
· Very heavy bleeding
· Depressive thoughts
How can you screen for it?
Diagnosis for endometriosis is currently a difficult and drawn-out process with many women reporting an average of seven and a half years between seeking help for symptoms and a definite diagnosis.
Currently, the only definite way to confirm a diagnosis of endometriosis is to have a laparoscopy, where a small camera is inserted into the abdomen to look for endometriosis on the pelvic organs.
If endometriosis is found and diagnosed, treatment is likely to occur during that same laparoscopy.
The first step is to go to the doctor with a list of symptoms. Keeping a symptom diary is a good way to record the severity and frequency of symptoms. A doctor may perform an internal and external abdominal examination, test to rule out any infections mimicking endometriosis symptoms and request an ultrasound before referring for a laparoscopy.
How can you manage it (lifestyle factors)?
Exercise can alleviate some of the symptoms suffered and can also alleviate some of the depressive symptoms.
Stress management and building in time for relaxation, particularly when on your period, can help with the management of symptoms.
Dietary changes such as decreasing gluten, dairy and processed products while increasing fruit and vegetable intake can decrease the severity of symptoms (Vennburg, 2020).
Simple techniques to manage pain such as a hot bath or hot water bottle to help with stomach cramps and pelvic pain can also be beneficial.
Increasing your intake of fish, or taking an omega-3 supplement can help as this reportedly can reduce symptom severity as omega-3’s can have an anti-inflammatory effect.
How can you treat it?
There is no cure but there are treatments to help with the symptoms.
Non-steroidal anti-inflammatories can be used to relieve some of the symptoms, although constant long-term use of these may have negative consequences.
Hormonal contraceptives may also be prescribed to prevent hormonal fluctuations and alter menstruation.
Gonadotropin releasing hormone (GnRH)analogues injections can be used. These injections cause a temporary menopause so can reduce symptoms. They stop the production of oestrogen, preventing the lining of the uterus and the endometriosis tissue growing. However, these injections can decrease bone density, so advice is that women should receive hormonal replacement therapy alongside this to protect bone density. The injections are usually monthly.
During the laparoscopy used to diagnose endometriosis, the surgeon may also cut away or destroy (using laser or heat)the endometriosis tissue growing on the organs. This is a temporary solution as the tissue will grow back over time and the surgery will need to be repeated.
Surgery to remove the uterus (total hysterectomy) and ovaries and fallopian tubes (bilateral salpingo-oophorectomy)may be recommended. This would stop menstrual cycles completely and should get rid of symptoms. However, it is irreversible so is usually used as a last resort.
A nearly age of menarche (starting your period), and short cycle lengths have been consistently associated with endometriosis development (Parasar et al.,2017).
Increased alcohol and caffeine intake may also increase the risk of endometriosis.
As it may have genetic links, a family history of endometriosis can increase the risk of development.
*Disclaimer: Information and content from FitrWoman are intended as general information only and should not be substituted for medical advice, diagnosis or treatment.